Presented by: Docia Baah

Tutor, NMTC - Teshie

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OUTLINE

 DEFINITION
 PREDISPOSING FACTORS
 DIAGNOSIS
 PHARMACOLIC TREATMENT
 NURSING MANAGEMENT
 COMPLICATION &
 PREVENTION

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DEFINITION
 Asthma is a chronic inflammatory disease of the
airways that causes airway hyperresponsiveness,
mucosal edema, and mucus production.

 This inflammation ultimately leads to recurrent

episodes of asthma symptoms: cough, chest
tightness, wheezing, and dyspnea

 In Ghana, Asthma is episodic and may be associated

with seasons like the rainy season or harmattan.
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N.B

 Bronchial asthma occurs at all ages but peaks

in childhood. It is classified as an allergic
disease, which may be due to an external or
intrinsic agent.

 The disease is associated with a personal or

family history of hay fever, eczema or
urticaria.

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PREDISPOSING FACTORS

1. Allergens − house dust, animal hairs, strong scents, etc.

2. Drugs e.g. beta−blockers (e.g. Propranolol),

Prostaglandin F2a and Aspirin

3. Environmental e.g. air pollution and climatic changes.

4. Occupational exposure to industrial chemicals, dust

and drugs.

5. Infections − viral or bacterial

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Pathophysiology

 The underlying pathology in asthma is

reversible and diffuse airway inflammation
that leads to airway narrowing.

 This narrowing, which is exacerbated by a

variety of changes in the airway, includes
bronchoconstriction, airway edema, airway
hyper responsiveness, and airway
remodeling.
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SIGNS AND SYMPTOMS

1. Episodic breathlessness
2. Cough
3. Wheeze (the sound of airflow through
narrowed airways), first on expiration and
then possibly during inspiration as well.
4. Tachypnoea (fast breathing)
5. Rhonchi
6. Use of accessory muscles of respiration

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Features of a life threatening attack are:

1. Inability of patient to speak full sentences in

one breath
2. Rapid pulse > 140/min
3. Rapid respiration > 40/min
4. Cyanosis
5. Silent chest on auscultation
6. Drowsiness or confusion

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DIAGNOSTIC INVESTIGATIONS

1. History of signs and symptoms

2. FBC

3. Chest X−ray

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Pharmacologic management

1. Smooth muscle relaxants eg.

 (albuterol
 Salbutamol
 Proventil,
 Ventolin,
 levalbuterol )

These are the medications of choice for relief of

acute symptoms and prevention of exercise-induced
asthma
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 Cont’d
2. Corticosteroids are the most potent and
effective anti inflammatory medications
currently available.
Eg.
 Prednisolone, oral, 20−40 mg daily or
Hydrocortisone, IV, 100 mg 8 hourly.

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Cont’d

3. Bronchodilators
This is a mild to moderate bronchodilator that is
usually used in addition to inhaled corticosteroids,
mainly for relief of nighttime asthma symptoms.
Eg. Theophylline or Aminophylline

4. Antibiotics in case of viral or bacterial infection

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NURSING MANAGEMENT

1. Reassure patient and family members to allay

fear and anxiety

2. Nurse patient in the fowler’s or semi fowler’s

position and loosen all tight clothing to aid in
easy breathing

3. Check and record patient’s vital signs including

T,P,R,BP and SPO2. Intervene appropriately and
report to the ward in charge any abnormality
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Cont’d

3. Administer medications as prescribed and monitor

the patient’s responses to those medications.

4. Give Oxygen, intranasal or by mask as prescribed

by the physician

5. Administer prescribed IVF and encourage copious

fluid intake. This aids to correct dehydration and
also loosens mucus for easy expectoration

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COMPLICATIONS
 Complications of asthma may include:

1. Status asthmaticus

2. Respiratory failure

3. Pneumonia,

4. Atelectasis and

5. Airway obstruction, particularly during acute asthmatic episodes,

often results in hypoxemia, requiring the administration of oxygen

and the monitoring of pulse oximetry and arterial blood gases.

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PREVENTION

1. Patients with recurrent asthma should undergo tests to

identify the substances that precipitate the symptoms.

2. Possible causes are dust, dust mites, certain types of

cloth, pets, detergents, soaps, certain foods, molds, and
pollens.

3. Patients are instructed to avoid the causative agents

whenever possible.

4. Knowledge is the key to quality asthma care.

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